As hospitals and outpatient facilities resume surgeries according to federal and state guidelines, ensuring the availability of surgery-critical resources will be top of mind.
Suzanne Champion, RN, director of Clinical Operations at Cardinal Health and a former OR nurse and clinical coordinator, shares five tips to help facilities tackle this challenge.
- Keep scrub staff in the OR after they’ve prepped a case.
While typical practice may be for scrub staff to leave the operating room after prepping a case, Champion says that facilities should rethink this practice. That’s because each time a staffer leaves the OR, personal protective equipment (PPE) such as a mask, gloves and gown are wasted – all precious resources in the current environment. Facilities could consider having staff prep a surgery closer to the time of the case, so they can remain in the OR immediately afterward without having to don new protective equipment. - Consider how the latest intubation recommendations may impact your allocation of resources
According to the latest intubation recommendations1, a room should be closed off for approximately 20 minutes (depending on the air exchange rate of the room) following an intubation procedure due to the risk of infectious aerosols spreading. This recommendation applies for extubation procedures as well. Because of this, Champion says facilities should be cognizant of their allocation of personnel because staff should remain in the room during this 20-minute period. She also advises that only essential staff be present for these procedures to conserve resources. - Eliminate or limit surgery staff breaks during surgery
Again, because staff have to discard precious PPE each time they leave the OR, Champion advises seriously limiting breaks –ideally, keeping staff in the OR for the entire surgery when it’s reasonable to do so. Champion also advises facilities to think through how to increase clinician comfort in the OR and alleviate undue burden like heat stress. - Be aware that you may need to adjust your scheduling system
Because surgery scheduling is often done through specific software, the calculated times are based on the system logic and historical data from prior surgeries. However, surgery times may now be affected by the latest intubation recommendations and other factors. Because of this, Champion warns that facilities may need to adjust scheduling systems manually or accommodate for additional time needed for surgeries. - Emphasize using the right level of protection at the right time
Old habits sometimes die hard, but given current circumstances, Champion says facilities will need to put an even greater emphasis on using the right level of protective equipment at the right time to conserve and extend the most surgery-critical items. For example, Champion says that OR personnel often grab surgical gloves out of habit, even when the protection they provide may not be required. Facilities will have to emphasize that surgical gloves should be limited to surgeries, and exam gloves should be used in other situations (e.g. starting an IV or helping move a patient to an OR bed). That holds true for masks as well – N95 masks should be limited to the most critical needs, while surgery and procedure masks should be used in other situations.
While ensuring your facility has the surgery-critical resources it needs will be an ongoing challenge, these five tips can help as your facility resumes surgeries. The Association of periOperative Registered Nurses, American College of Surgeons, and the American Society of Anesthesiologists have additional resources to offer guidance on this topic.
For more information on how Cardinal Health is addressing COVID-19, and additional resources and tools, visit cardinalhealth.com/covid19.
1https://www.apsf.org/covid-19-and-anesthesia-faq/